Our search of the English literature revealed that the first case of an epididymal cholesterol granuloma was reported by Nistal and colleagues.
Although the exact pathogenesis of cholesterol granuloma is unknown, it is believed that a non-infectious local reaction induces ischemic necrosis, granulomatous reaction, and scarring.
Sinonasal cholesterol granuloma usually presents in patients with a history of rhinitis or sinus disease (or sinus surgery) with facial pain, headache, nasal obstruction, and nasal discharge.
Cholesterol granuloma is treated with radical surgical techniques and an endoscopic approach.
In conclusion, patients with a large petrous apex cholesterol granuloma may experience extensive bone erosion involving the jugular foramen, carotid canal, and internal auditory canal.
Occasionally a cholesterol granuloma will demonstrate an area of hypointensity on MRI as a result of a solid mineral content within the cyst.
This article describes the presentation of a cholesterol granuloma
in a patient with a paraganglioma, or glomus jugulare tumor.
Several different factors can cause the tympanic membrane to assume a blue color, including a true hemotympanum, an idiopathic hemotympanum secondary to a cholesterol granuloma
, long-standing secretory otitis media, a dehiscent high-riding jugular bulb, and occasionally a chemodectoma.
Patients 1 and 2 exhibited compression and erosion of the endolymphatic sac and duct by a jugular megabulb and a cholesterol granuloma
The factors necessary for the development of a cholesterol granuloma
are hemorrhage, interference with clearance or drainage, and obstruction of air exchange or ventilation.
It is presumed that the formation of a cholesterol granuloma
is caused by an obstruction of the air cells in the petrous apex.
Survey of Published Cases With Cholesterol Granulomas
Associated With Pulmonary Hypertension and Comparison With the Present Case